FOOD SAFETY • CID 2006:42 (1 March) • 000
F O O D S A F E T Y I N V I T E D A R T I C L E
Frederick J. Angulo, Section Editor
Human Health Implications of Salmonella-Contaminated
Natural Pet Treats and Raw Pet Food
Rita Finley,1Richard Reid-Smith,2,3and J. Scott Weese4
1Foodborne, Waterborne, and Zoonotic Infections Division and
2Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, and Departments of
4Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
Human salmonellosis occurs mainly as a result of handling or consuming contaminated foodproducts,withasmallpercentage
of cases being related to other, less well-defined exposures, such as contact with companion animals and natural pet treats.
The increasing popularity of raw food diets for companion animals is another potential pet-associated source of Salmonella
organisms; however, no confirmed cases of human salmonellosis have been associated with these diets. Pets that consume
contaminated pet treats and raw food diets can be colonized with Salmonella organisms without exhibiting clinical signs,
making them a possible hidden source of contamination in the household. Pet owners can reduce their risk of acquiring
Salmonella organisms by not feeding natural pet treats and raw food diets to their pets, whereas individuals who investigate
cases of salmonellosis or interpret surveillance data should be aware of these possible sources of Salmonella organisms.
Dogs and cats play an integral part in the lives of humans,
providing security, labor, therapeutic support, and compan-
ionship. In 2002 in the United States, dog and cat populations
were estimated to comprise 65 million and 78 millionanimals,
respectively . Dogs are present in 39% of US households,
and cats are present in 34% of US households . Dogs and
cats live in close contact with their owners, sharing their
homes and immediate environment. In 2002, 41% of dogs
and 53% of cats were reported to share their owner’s bed, an
∼20% increase in this behavior since 1998 . In many re-
spects, people have more frequent and close contact withtheir
pets than with most other people.
North American pet owners are spending increasing sums
of money on a growing variety of pet products and services
. Pet treat manufacturers are making available anexpanded
range of pet treats. Pig ear treats and other treats made from
animal parts, such as bull penises and cow hooves, have be-
come popular as “natural” pet treat alternatives. A relatively
new trend in pet food is “biologically appropriate” or raw
food diets, as typified by the Bones and Raw Food Diet
Received 19 August 2005; accepted 16 November 2005; electronically published 20 January
Reprints or correspondence: Rita Finley, 160 Research Ln., Unit 206, Guelph, Ontario, N1G
5B2 Canada (Rita_Finley@phac-aspc.gc.ca).
Clinical Infectious Diseases 2006;42:000–000
? 2006 by the Infectious Diseases Society of America. All rights reserved.
(BARF) . Recipes for homemade raw food diets are avail-
able from a variety of sources, and commercial versions are
available from suppliers, pet stores, and some veterinarians
as premade frozen meals consisting of raw meats, grains, and
vegetables to be served raw as the animal’s main meal. These
diets are widely touted by their proponents as being more
appropriate than commercial pet foods and as resulting in
improved coat quality, health, immune status, and longevity
; however, there currently are no objective data that sup-
port any of these claims. Raw food diets have becomeasubject
of considerable disagreement among veterinariansandowners
of companion animals over the past few years, with respect
to their nutritional benefits and the risk that they pose to the
health of animals and humans [3–5]. There is no available
information on how common the use of a raw food diet is,
but it is estimated that ∼40% of dog owners purchase natural
pet treats 5 times per year, on average .
Dogs and cats are potential sources of several zoonotic
diseases, including salmonellosis. An emerging concern with
respect to Salmonella carriage in pets is the role of natural
pet treats and raw food diets, which are produced with little
to no regulatory oversight in the United States and Canada
. Overall, there is a lack of information on how natural
pet treats and raw food diets can affect the health of pets and
their owners, both in general and with respect to Salmonella
000 • CID 2006:42 (1 March) • FOOD SAFETY
SALMONELLA SPECIES IN HUMANS
It has been estimated that 1.4 million people are infected with
Salmonella organisms annually in the United States [7, 8]. The
illness is usuallyself-limiting,but∼15,000casesofsalmonellosis
result in hospitalization of the infected individuals, and 500 of
the total number of cases are fatal each year . Although
∼95% of cases of nontyphoidal salmonellosis in humans are
associated with foodborne contamination, an unknown pro-
portion of these cases are the result of contact with infected
pets and contaminated pet food products. Sporadic cases,some
of which could be caused by pet exposure, usually are not
investigated thoroughly or reported to the local health au-
thorities, especially cases that occur in adults. In the United
States, it is estimated that 1% of the number of cases of sal-
monellosis reported annually are associated with contact with
companion animals .
There have been a limited number of reports of humanswith
Salmonella infection associated with exposure to ill or subclin-
ically affected dogs living in the same household [10–12].There
have also been several recent outbreaks of salmonellosis asso-
ciated with companion animal veterinary clinics and animal
shelters, consisting of the spread of Salmonella organisms from
cats to humans and other animals [13, 14].
SALMONELLA SPECIES IN DOGS AND CATS
Clinical salmonellosis in dogs is similar to salmonellosis in
humans, and symptoms may include fever, malaise, vomiting,
abdominal pain, and diarrhea. Cardiovascular collapse and
shock can occur, as can systemic infection, generally in pedi-
atric, geriatric, or immunocompromised patients . There
is little information on the duration of Salmonella colonization
in dogs; however, it has been widely quoted that, once infected,
a dog can shed Salmonella organisms in its feces for ?6 weeks,
continuously for the first week and then intermittently[10,16].
The estimated prevalence of Salmonella organisms in normal,
healthy dogs is 1%–36% , and numerous Salmonella se-
rotypes have been identified , with Salmonella serotype Ty-
phimurium and Salmonella serotype Anatum identified most
commonly in the United States . A recent study of 188
healthy dogs in southern Ontario, Canada, found that no dogs
were colonized with Salmonella organisms ; however, this
finding may, in part, be related to the use of rectal swab spec-
imens instead of fecal samples and/or use of a single sample
rather than serial samples. A case-control study of 60 diarrheic
and 60 nondiarrheic dogs in northern California similarly
found that no dogs were colonized with Salmonella organisms,
but it also relied on a single fecal sample for culture .
Because dogs with Salmonella colonization intermittently shed
the organisms in feces, studies that have relied on single sam-
ples, particularly low-volume samples collected by rectal swab,
may have underestimated the true prevalence of Salmonella
carriage by dogs.
Sources of Salmonella organisms in dogs are various and
include consumption of infected rodents and rabbits, copro-
phagia, and consumption of Salmonella-contaminated foods
[18, 21]. To date, there have been no published reports of
salmonellosis occurring in dogs as a result of exposure to nat-
ural pet treats. Anecdotal reports of canine illness werereceived
during the investigation of a human salmonellosis outbreak
caused by Salmonella serotype Infantis in Canada in 1999 (P.
Sockett, unpublished data). Five (11.4%) of 44 dog owners
indicated that their dog had been ill during the week before
the onset of their own illness and that their dog also had a
history of exposure to pig ear treats.
There have been reports of racing sled dogs, racing grey-
hounds, and guard dogs with Salmonella infections due to con-
sumption of contaminated raw meat [22–24]. Commercially
available raw food diets are a relatively new product, and there
have been no reports associating them with clinical salmonel-
losis. Fecal shedding of Salmonella organisms was evaluated in
20 dogs in Calgary, Alberta, Canada, to determinewhetherdogs
would shed the organism after consumption of homemade raw
food diets . Salmonella organisms were isolated from 30%
of the 10 dogs that were fed homemade raw food diets, but
they were isolated from none of the 10 dogs that were fed
commercial dry food. None of the dogs exhibited clinical signs
of salmonellosis. Of the dogs with Salmonellacolonization,only
1 had the same serotype (Salmonella serotypeSchwarzengrund)
isolated from both its food and a stool sample . In a similar
study conducted in 2004, research beagles were fed commercial
raw food diets identified as beingcontaminatedwithSalmonella
organisms. Five of the 7 dogs that shed Salmonella organisms
after consuming a raw food diet meal shed a Salmonella se-
rotype that matched the serotype isolated from the diet that
was fed . This study used commercial frozen raw food diets
that were naturally contaminated, and clinically healthy dogs
became colonized after ingestion of a single meal.
Salmonellosis in cats is similar to salmonellosis in dogs and
humans. In addition to exhibiting the usual clinical signs, cats
may also experience abortion and demonstratehypersalivation,
conjunctivitis, and chronic febrile illness that canoccurwithout
diarrhea [27, 28]. Sources of Salmonella organisms in cats are
various, but they are dependent on whether cats are indoor or
outdoor cats. For indoor cats, the most likely exposure is con-
sumption of food contaminated with Salmonella organisms,
whereas outdoor cats may be exposed through scavenging and
hunting, especially the hunting of birds. The estimated prev-
alence of Salmonella carriage among healthy cats is 1%–18%
, with a variety of serotypes having been identified in the
United States, including S. Typhimurium, Salmonella serotype
Enteritidis, S. Anatum, and Salmonella serotype Derby .
FOOD SAFETY • CID 2006:42 (1 March) • 000
To date, there has been only one published report of sal-
monellosis occurring in cats as a result of exposure to raw food
diets. Septicemic salmonellosis was diagnosed in 2 cats that
versity of Georgia (Athens, GA). Salmonella serotype Newport
was recovered from raw meat that had been fed to both cats,
and these isolateswereindistinguishablefromisolatesrecovered
from the intestines and lungs of one of the animals .
SALMONELLA SPECIES IN NATURAL PET
TREATS AND RAW FOOD DIETS
Pet treats of animal origin have been associated with human
salmonellosis in both Canada and the United States. In 1999,
an outbreak of human salmonellosis caused by S. Infantis was
identified. An increase in the number of cases of infection due
to S. Infantis was seen across the country, compared with the
number of cases seen during the same period in 1998 (P. Sock-
ett, unpublished data). In Alberta, Canada, 9 of 12 case patients
with S. Infantis infection had been exposed to pig ear treats
, and S. Infantis was isolated from a pig ear treat collected
from the household of one of the case patients. The isolate
recovered from the pig ear had the same phage type, and, on
PFGE, it was indistinguishable from S. Infantis isolates recov-
ered from fecal samples obtained from humans with salmo-
nellosis . A nationwide survey was conducted to investigate
all laboratory-confirmed cases of S. Infantis infection. Thirty-
five (41.2%) of all case patients identified reported havingbeen
exposed to pig ears before the onset of their illness (P. Sockett,
unpublished data). A case-control study showed an OR of 7.9
(95% CI, 1.6–75.5) for exposure to pig ear treats among dog
As part of the investigation of the outbreak, samples of pig
ear treats were obtained from retail outlets in the province of
Alberta and from several pet treat plants across the country.
Salmonella organisms were isolated from 48 (51%) of 94 pig
ear samples obtained from retail outlets . Salmonella or-
ganisms were also found in products associated with outbreaks
that occurred in 5 (42%) of the 12 pet treat plants visited,
whereas 49 (29%) of 171 pig ear treats collected contained
Salmonella organisms . Nineteen Salmonella serotypeswere
isolated from all sources combined, including S. Infantis (18%
of isolates from pig ear treats), S. Typhimurium (11%), and S.
In 2002, also in Calgary, a smaller outbreak caused by S.
Newport PT 14 was identified. The index case patient was a 1-
month-old infant. Other case patientsidentifiedintheoutbreak
were the sister and father of the index case patient and 2 in-
dividuals with no connection to the family of the index case
patient. No Salmonella isolates were obtained from either the
environmental or pet stool samples obtained from the 3 house-
holds affected; however, S. Newport PT 14 was isolated from
a commercial pet treat obtained from the property of one of
the unrelated individuals. All 3 households fed the same pet
treat, a dried beef patty imported from Texas. PFGE showed
that the strains recovered from the humans and the pet treats
found to be indistinguishable from the strain recovered from
thepet treats .Therewasathirdpettreat–associatedhuman
outbreak that occurred in 2005; this outbreak was due to Sal-
monella serotype Thompson. Few details were available at the
time that this article was written; however, it appears that 5
cases of infection, 3 of which occurred in Canada and 2 of
which occurred in the United States, developed among people
who handled pet treats from a single manufacturer [32, 33].
As a follow-up to the 1999 outbreak in Canada, the US Food
and Drug Administration (FDA) conducted a national survey
of animal-derived pet treats in which 158 treats, both domestic
and imported, were sampled. Sixty-five treats (41%) were con-
The most common serotypes were S. Anatum (19% of 78 iso-
lates serotyped), S. Typhimurium (14%), S. Infantis (10%), S.
Derby (8%), and Salmonella serotype Ohio (8%). A total of
36% of isolateswereresistanttoatleast1antimicrobial,whereas
13% were resistant to ?4 antimicrobials.
To date, raw pet foods have not been associated with sal-
monellosis in humans; however, identification of Salmonella-
contaminated food and Salmonella shedding by pets that have
been fed raw food diets should raise concern. A 1993 study of
112 samples of raw meat used in greyhound diets reported
recovery of Salmonella isolates from 50 samples (44.6%). Of
the 13 serotypes isolated, S. Typhimurium was identified most
frequently (in 48% of samples) . Isolates were resistant to
ceftiofur, clindamycin, erythromycin, penicillins, sulfadime-
thoxine, and tetracycline . In a study of homemade raw
food diets that was conducted in Calgary, Salmonella species
were isolated from 8 (80%) of 10 samples. Three different
serotypes (Salmonella serotypeBraenderup,Salmonellaserotype
Hadar, and S. Schwanzengrund) were identified . In 2 re-
cent surveys of commercial, frozen raw food diets, the first of
which was conducted in southern Ontario and the second of
which was conducted in southernOntarioandCalgary,5(20%)
of 25 samples and 35 (21%) of 166 samples, respectively, were
contaminated with Salmonella species [26, 36]. The suscepti-
bility patterns observed were similar to those that the Canadian
Integrated Program for Antimicrobial Resistance Surveillance
reported for chicken meat, which is the principal component
of the majority of Salmonella-contaminated commercial raw
food diets for which samples have beenavailable.Similarresults
were observed by researchers in Fort Collins, Colorado, who
isolated Salmonella species in 10 (48%) of 21 samples of com-
mercial raw food diets sampled .
000 • CID 2006:42 (1 March) • FOOD SAFETY
PET FOOD REGULATIONS AND GUIDELINES
Food regulatory agencies provide specific guidelines on the
manufacture and labeling of food; processing plants need to
follow these guidelines to guarantee the integrity and quality
of the food being produced for consumption by humans, to
reduce or limit the risk of illness or death posed by food prod-
ucts. Although natural pet treats and raw food diets are made
from animal by-products, they are not considered to be “fit for
human consumption,” and, as such, they are not subject to the
same regulations as is food intended for humans. No federal
human agency in the United States or Canada oversees or reg-
ulates the market, other than to provide guidance regarding
ingredients, labeling, health claims, and permits required for
the production and importation of pet food [38, 39].
In the United States, 2 sets of guidelines have recently been
created, 1 for the manufacturing of natural pet treats and 1 for
the manufacturing and labeling of raw meat foods for com-
Pet Treats for Pets  have been reviewed by members of the
American Pet Product Manufacturers Association, as well as
by the FDA, and adherence to these guidelines is completely
voluntary. The main purpose of the guidelines is to promote
and advance the manufacturing of uncontaminated pet treat
products. The document Guidance for Industry: Manufacture
and Labelling of Raw Meat Foods for Companion and Captive
Non-Companion Carnivores and Omnivores  was created to
provide to the industry more-specific guidance on how such
products should be manufactured and labeled so that pet own-
ers and pets may be protected from risks involving food safety.
The risk to human health posed by the handling and feeding
of pet treats and raw food diets remains unquantified,although
data are accumulating to the point that formal quantified risk
assessment may be possible and well-designed epidemiologic
studies may be conducted. Factors contributing to the lack of
information include the ability of dogs and cats to shed Sal-
monella species without exhibiting clinical signs of illness, the
underreporting of health risks by those in human medicine or
companion animal veterinary medicine, and the limited infor-
mation regarding risk factors for Salmonella infection in com-
colonization and salmonellosis in dogs and cats is principally
a consequence of the cost to pet owners of culture and sus-
ceptibility testing, as well as the lack of a formal system for
collecting data on zoonoses in companion animals.
Dog and cat owners should be made more aware of the
zoonotic risks, including salmonellosis, that are associated with
diarrheic illness and asymptomatic carriage in dogs and cats
and, also, of the potential risks associated with naturalpettreats
and raw food diets. Owners of animals receiving natural pet
treats and raw food diets should be educated about safe han-
dling of their pet and pet feces, cleaning and disinfection of
contaminated areas inthe household,restrictionofcontactwith
humans who might be at higher risk for developing disease
(i.e., immunocompromised, antimicrobial-treated, very young,
and elderly populations), and appropriate hand hygiene. Of
issue is the potential introduction of antimicrobial-resistant
pathogens into the community through contaminated natural
pet food products, which could contribute to (1) the failure of
treatments for Salmonella infections or other bacterial diseases
that require antimicrobial therapy, or (2) an increase in the
number and severity of these infections. Dogs that are used for
socialization and therapy at hospitals and long-term care fa-
cilities also should not be exposed to raw food diets, pig ear
treats, and other pet treats made of dried animal parts, unless
it is clear that the products used are pathogen free. It is possible
that dogs used for socialization and therapy purposes could
carry Salmonella organisms with resistance to various antimi-
crobials, including third-generation cephalosporins, which
could interfere with other treatments that the patients and se-
nior citizens at hospitals and long-term care facilities might
require. Further study of the incidence of salmonellosis andthe
prevalence of Salmonella carriage in dogs and cats should be
undertaken, as should analysis of the associated risk factors.
We have observed the frequent absence of labels or educa-
tional materials included in the packaging or available at the
point of sale of pet treats made of dried animal parts and
commercial raw food diets. In some instances, naturalpettreats
are sold in bulk bins without any packaging material or in-
structions available to buyers regarding thehygienicprocedures
to follow after handling the products. Depending on the level
of hygiene practices followed, pet owners could contaminate
cooking utensils when preparing the pet’s meal. Feeding areas
could also be contaminated and could represent a source of
exposure. This could lead to illness developing in members of
the household, especially children and immunocompromised
persons. Children could also have direct contact with pet treats
if the treats are not stored in a secure location. The risk posed
by these products is not limited tohouseholdmembers,because
some dogs and cats are used for therapeutic visits to hospitals
and long-term care facilities for senior citizens. Objective evi-
dence of the risk of zoonotic transmission of Salmonella or-
ganisms by dogs and cats used for therapeutic visits is currently
lacking. However, considering that many hospitalized humans
are presumably more susceptible to infection, it is reasonable
to require that such pets not be fed natural pet treats or raw
Recognizing that a percentage of cases of salmonellosis in
North America are sporadic, physicians and public health of-
ficials should make further inquiries regarding those cases that
FOOD SAFETY • CID 2006:42 (1 March) • 000
developed without an obvious source of exposure and, in par-
ticular, those that developed when dogs or cats were present
in the household. Investigators should consider asking about
the products that owners feed their pets, in particular pet treats
and raw foods. Environmental samples should be collected
from the animal’s feeding area, along with stool samples, and
they should be tested for the presence of Salmonella organisms,
even if the animals appear to be healthy. Stool samplecollection
and testing should be repeated for several days, because pets
may be transiently colonized and may continue to be a vehicle
for the spread of infection over a period of time. Overall, pet
owners can reduce the risk of their pets acquiring Salmonella
infection, as well as the risk of acquiring human salmonellosis,
by not feeding natural pet treats and raw food diets to their
pets that have not been cleared for bacterial contamination.
We thank Dr. Paul Sockett, Director of the Foodborne, Waterborne, and
Zoonotic Infections Division, Public Health Agency of Canada, Guelph,
Ontario, Canada, for his critical review of the manuscript.
Potential conflicts of interest.
All authors: no conflicts.
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